Provider Demographics
NPI:1174312078
Name:HAMILTON, SPENCER B (CIEC #23060)
Entity type:Individual
Prefix:MR
First Name:SPENCER
Middle Name:B
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:CIEC #23060
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-2507
Mailing Address - Country:US
Mailing Address - Phone:609-703-1311
Mailing Address - Fax:609-703-1311
Practice Address - Street 1:104 SHORE RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-2507
Practice Address - Country:US
Practice Address - Phone:609-703-1311
Practice Address - Fax:609-703-1311
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ13VH04976900171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications